Between the convention and conventional practice: Israeli social workers' recommendations regarding the legal capacity of people with disabilities.
Roni Holler, Shirli Werner
PMID 35146852WHAT IT FOUND
Israeli social workers recommended guardianship as a default for people with intellectual disabilities, often ignoring supported decision-making options.
They assessed capacity by whether clients made 'wise' decisions and relied heavily on family support. Client preferences were rarely explored independently, especially for non-verbal individuals.
Key findings
01Social workers viewed guardianship as a mandatory or default solution for people with intellectual disabilities, particularly those with moderate to severe conditions, rarely questioning the need for it.
02Assessments of decision-making capacity were inconsistent, often conflating the ability to understand information with the ability to make 'wise' or socially desirable decisions, and assuming capacity was static rather than improvable with support.
03Client preferences were seldom sought independently; when asked, it was often after family agreement, and information was presented selectively to encourage acceptance of guardianship, with non-verbal clients frequently excluded from the process.
STILL TO COME
How it was doneWhat they found
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What it does not show
The sample was a convenience group of 27 Jewish-Israeli social workers, limiting generalizability to other cultures, religions, or professional groups. Findings may be influenced by social desirability bias, as participants discussed highly controversial and ideological topics. The study did not observe actual decision-making processes in real time, relying instead on retrospective accounts.
Declared interests
Funded by the Israel Science Foundation. No other conflicts of interest were declared.
The easy way to misread this
Do not interpret these findings as evidence that guardianship is clinically necessary for people with intellectual disabilities. The study reports social workers' subjective recommendations and biases, not objective outcomes of patient care or the effectiveness of guardianship itself.